Idiopathic thrombocytopenic purpura in children: should corticosteroids be given?

Life-threatening hemorrhages occur in about 2% of children with idiopathic thrombocytopenic purpura (ITP), the majority during the first month of illness. The administration of corticosteroids to patients with ITP has been shown to improve platelet economy mainly through reduction of phagocytosis in the spleen. Since the risk of a short course of steroids in low dosage is small, it seems reasonable to administer them to patients with ITP during the period of greatest risk.